Severe atherosclerosis and a bewildering reticulated rash

Abstract

A 60-year-old Chinese woman presented with a 3-week history of painful rash over her lower abdomen and thighs. Her medical history included ischemic heart disease, severe atherosclerosis with chronic occlusion of the infrarenal aorta, diabetes mellitus, hypertension, and hyperlipidemia. Physical examination revealed erythematous to dusky-brown, non-blanchable patches on the hips and thighs, and reticulated macular streaks on the lower abdomen (Fig. 1). Some of the dusky patches subsequently developed necrosis and ulceration.